BackgroundSince the publication on 6 April 2011 of the ‘Decree on the quality management of medicinal treatment and drugs in health institutions’, it has become a priority in hospitals. In addition, in the 2010 version of the High Authority of Health Certification manual, criterion 8d deals with the evaluation requirements and risk prioritisation based on defined methods, implementation of preventive, mitigation or recovery actions, staff training in risk analysis, and monitoring and measuring the effectiveness of the implemented actions.PurposeIt is in this context that the Organisation, Quality, User Relations Directorate of our health institution has requested that the medical device vigilance service initiate a project on quality management and develop a materiovigilance ex ante risk assessment tool. The chosen quality tool was a risk mapping, based on the FMEA method (failure mode effects analyses) which allows prioritisation of risks to identify actions for improvement and to develop an action plan.Material and methodsFirst the project leader contacted stakeholders to create a multidisciplinary group. Then an inventory of the service documentary system was performed. In parallel, the development of the risk mapping was started with analysis of the process and identification of the associated risks. The causal factors and impact of the risks on global process were analysed. Then a quotation of risk frequency and acceptability in terms of patient incidence was created in order to calculate a gross criticality. Finally, actions for improvement were identified. A risk quotation of feasibility of setting up these actions was developed in order to calculate a net criticality. Through this work, priority risks were identified.ResultsFive major activities, about 50 associated risks and many scenarios were identified. Due to the risk mapping, three priority actions have been identified to be implemented: reinforce staff training, raise awareness on declaration and write service continuity procedures. These actions were included in the action plan for 2016.ConclusionThe development of this quality tool was made in the context of the certification of health institutions as well as in the context of a comprehensive approach to improve quality management and patient care in hospitals.References and/or AcknowledgementsManuel de certification des établissements de santé v2010. HAS, 2011.No conflict of interest.
Eur J Hosp Pharm 2013;20(Suppl 1):A1-238 A95• • the time spent using the original system and the new one over a period of one week, The questionnaires were carried out on the wards, pharmacy and with the staff in charge of the setting up. Then we gave a value to the times collected using the amount charged for salaries in 2011.The amount of products returned to the pharmacy was used as an indicator of the cost savings between the two systems. We also collected the cost of furniture.We finally made an amortisation schedule of the collected costs. Results Eight out of the eleven wards answered the self-assessment questionnaire. The value of staff time saved with the two bin replenishment system was found to be €13,800 per year. The difference in cost between the new and the original stock was around €7600. We compared these savings with the cost of setting up the new system. It cost €24,500 in manual labour expenses and €35,600 for the furniture and renovation works.The amortisation schedule shows a return on investment in 3 years. Conclusions This study reinforced our wish to develop this type of replenishment in our other public hospitals as its safety benefit has been published in a previous report (MEAH report -September 2006). . eHealth strategies worldwide aim to promote quality, safety and efficiency by underpinning shared healthcare provision with technology. The Scottish eHealth Strategy incorporates an ePharmacy programme to support pharmacists' increasing role in shared care [2]. It acknowledges organisational development and training for core and optional eHealth services as key. Purpose To explore and report methodologies, findings and gaps in research related to healthcare professionals' perceptions of the adoption of eHealth technologies for shared care. Materials and Methods A systematic review was conducted using a meta-narrative approach [3]. Articles published post-2004 in English were included; articles on Internet searches for health information or email were excluded. Data were extracted, synthesised and summarised. Ethical approval was not required. Results Screening reduced the initial 327 papers identified to 12 which included three reviews, four qualitative, two mixedmethods and three quantitative studies. Data were collected using questionnaires (3), case study (1), group (2) and individual (6) interviews, observation (3) and extraction of data from records (1). Practice settings were remote rural or urban featuring primary care, secondary care or both. The focus was on electronic records (7), telemedicine (2) or general eHealth implementation (3) from the perspective of doctors, nurses, IT developers, policy makers and managers. One study included the views of a hospital pharmacist. Acceptance of eHealth technologies is reported but with cost effectiveness, resourcing and training questioned. Emerging themes are organisational, social and technical.
BackgroundThe central pharmacy orders 2,100 different drugs from over 80 suppliers. Its main mission is to ensure the continuous delivery of drugs in care units. Backorders are daily verified in order to avoid out of stock situation.PurposeThe objectives are to identify classes of drugs most frequently impacted and to present an organisational pattern to prevent interruption in patient’s treatment.Material and methodsWe retrospectively analysed all stock-outs between January 2014 and September 2014 in the central pharmacy, based on warnings notes we sent to care units. We identified classes of drugs most frequently impacted, we listed the solution implemented in each case, then regarding to most suitable solution we built an organisational pattern to overcome out of stock.ResultsDuring the study, 63 stock-outs occurred; 36% of stock-outs involved anti-infective agents, 21% involved nervous system drugs, remaining 43% equally affected 9 other classes of drugs.5 different solutions were identified, ranked toward their pertinence and future place in the organisational pattern:12% solved by changing primary packaging (volume, number of tablet in the package)32% solved by a drug switch (princeps/generic) including 9% solved by an importation managed by national agency of medicines18% solved by changing pharmaceutical form18% solved by changing dosage20% solved by a drug substitution (same ATC class)ConclusionThe study resulted in a classification of the solutions regarding their priority and the development of an organisational pattern to face efficiently future stock-outs. It’s also important to get the information as soon as possible to act quickly. In fact, 11 stock-outs were notified on the national agency of medicines website. In this context, tracking orders and minimum stocks are very useful tools to prevent out of stock situation and discontinuity in patient treatment.References and/or acknowledgementsNo conflict of interest.
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